Nephrectomy — Procedure Guide, Recovery & Risks | MyMedicPlus

Nephrectomy is the surgical removal of one kidney — partial or radical — to treat renal cell carcinoma, a non-functioning or infected kidney, living donor transplantation, or severe renal trauma.

Indicated for renal cell carcinoma, non-functioning or chronically infected kidney, renal artery aneurysm, living kidney donation, polycystic kidney causing severe symptoms, and renal tumours not amenable to ablation.

Performed laparoscopically or robotically through 3–4 ports, or open via flank incision. The renal artery and vein are ligated first (radical) or parenchyma margins secured (partial). The kidney is removed in an extraction bag.

Laparoscopic nephrectomy allows discharge in 1–2 days; open surgery requires 3–5 days. Light activities resume in 2–3 weeks; full recovery in 4–6 weeks. The remaining kidney undergoes compensatory hypertrophy over 3–6 months.

Risks include haemorrhage requiring transfusion in 2–5%, adjacent organ injury to spleen or bowel, ileus, urine leak after partial nephrectomy, port-site hernia, and long-term risk of chronic kidney disease.

Laparoscopic radical nephrectomy for T1–T2 tumours achieves 5-year cancer-specific survival of 90–95%. Partial nephrectomy provides equivalent oncological outcomes while preserving up to 80% of renal function in suitable patients.